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Radiographic prognosis of finger joint damage predicted by early alteration in synovial vascularity in patients with rheumatoid arthritis: Potential utility of power doppler sonography in clinical practice
- Source :
- Arthritis Care & Research. 63:1247-1253
- Publication Year :
- 2011
- Publisher :
- Wiley, 2011.
-
Abstract
- Objective To investigate the relationship between synovial vascularity and progression of structural bone damage in each finger joint in patients with rheumatoid arthritis (RA) and to demonstrate synovial vascularity as a potential therapeutic marker. Methods We studied 250 metacarpophalangeal (MCP) and 250 proximal interphalangeal (PIP) joints of 25 patients with active RA who were administered adalimumab or tocilizumab. Patients were examined with clinical and laboratory assessments. Power Doppler sonography was performed at baseline and at the fourth and eighth weeks. Synovial vascularity was evaluated according to quantitative measurement. Hand and foot radiography was performed at baseline and the twentieth week. Results Clinical indices such as the 28-joint Disease Activity Score, the Clinical Disease Activity Index, and the Simplified Disease Activity Index were significantly decreased by biologic agents. The MCP and PIP joints with no response in synovial vascularity between baseline and the eighth week (vascularity improvement of ≤70% at the eighth week) showed a higher risk of radiographic progression compared with responsive joints (vascularity improvement of >70% at the eighth week; relative risk 2.33–9). Radiographic progression at the twentieth week was significantly lower in responsive joints than in nonresponsive joints. Conclusion The improvement of synovial vascularity following treatment with biologic agents led to suppression of radiographic progression of RA in each finger joint. The alteration in synovial vascularity numerically reflected therapeutic efficacy. Using vascularity as a marker to determine the most suitable therapeutic approach would be beneficial for patients with active RA.
- Subjects :
- Adult
Male
musculoskeletal diseases
medicine.medical_specialty
Time Factors
Radiography
Arthritis
Pilot Projects
Antibodies, Monoclonal, Humanized
Severity of Illness Index
Arthritis, Rheumatoid
Metacarpophalangeal Joint
chemistry.chemical_compound
Tocilizumab
Vascularity
Japan
Rheumatology
Predictive Value of Tests
Finger Joint
medicine
Adalimumab
Humans
Aged
Observer Variation
business.industry
Synovial Membrane
Antibodies, Monoclonal
Reproducibility of Results
Middle Aged
medicine.disease
Surgery
Treatment Outcome
chemistry
Ultrasonography, Doppler, Pulsed
Antirheumatic Agents
Rheumatoid arthritis
Predictive value of tests
Disease Progression
Female
Finger joint
Radiology
medicine.symptom
business
medicine.drug
Subjects
Details
- ISSN :
- 2151464X
- Volume :
- 63
- Database :
- OpenAIRE
- Journal :
- Arthritis Care & Research
- Accession number :
- edsair.doi.dedup.....1efc86655d9857674327ec7fab6cc3e7